Bleeding on HRT

[stringbean]

I started HRT last summer after having no periods for a year - now 54 - Utrogestan and Sandrena gel 0.5mg, but was still getting hot flushes after 3 months so GP suggested increasing the dose of gel. The next dose of Sandrena was 1mg and I didn't want to double the dose at that point, so switched to Estradot patches 0.75mg - which I prefer to using the gel. It's certainly helped in terms of symptoms - hot flushes, anxiety, poor sleep in particular

Since switching to the patches in October I have had a few heavy bleeds - two of these were only a few weeks apart. Am I right in thinking I probably need a higher dose of progesterone to stop the endometrial wall building up? Is a 200mg dose usual? It seems a bit much but willing to try if it helps. Or would switching back to the gel be a better option? Would be grateful for any advice from anyone who's had a similar experience. I should go back to the GP but so bloody difficult to get an appointment at the moment, and it will be phone only anyway.

I didn't want your post to go totally unanswered @stringbean :)

The patch you are on is a lot more than the original 0.5mg Sandrena.

Patches are different in terms of strength- a patch of 0.75mcgs is the same as (roughly) 3mgs of gel.

If your GP gave you a 0.75mcg patch they were maybe confusing the strength of patches with oral tablets and gel.

www.womens-health-concern.org/help-and-advice/factsheets/hrt-types-doses-and-regimens/

See here.www.menopausematters.co.uk/treatafter.php

So you have increased your dose roughly 4 x and possibly 6 times.
Doubling the Sandrena to 1mg would still be a low dose. You are now on a high dose of patch.

You are not getting enough Utrogestan to control the bleeding. After 6 months, you ought to be getting a bleed-free result!

You could try reducing to a 37 or 50mcg patch or going back to Sandrena and using 1mg a day. OR using 200mgs Utrogestan daily.

Many thanks @JinglingHellsBells - really appreciate you pointing that out about the dosage: I had no idea about that!! Definitely going back to the GP in that case and will request a lower dose patch.